Emergency medical technology (EMT) students at San Jacinto College in Houston were plenty busy recently learning proper procedures for a rescue demonstration all the while dodging flying paintballs.

It was part of a training exercise that points to the importance of communication and teamwork, even during the heat of a scenario like a shooting or bombing. San Jacinto College North (there are two programs, North and Central) instructor and Army veteran, Ali Shah said the paintball exercise is a “watered down” version of the Tactical Combat Casualty Care course that soldiers experience in the military.

“We thought it was a good idea to get them in a stressful environment, where it’s not just us telling them how stressful it is, but out in the field where there is a realistic possibility they might get smacked in the head with a paintball,” Shah said.

The “care under fire” exercise is part of the curriculum for students interested in certifications and degrees in EMT and paramedic programs. The care under fire training prepares students interested in tactical EMT work, such as the medics who help SWAT teams during dangerous standoffs. Although those situations aren’t the norm for EMTs, recent events have shown that there is an element of danger in the work EMTs do.

“Care under fire is part of that course where you’re learning how to get your patients out of immediate danger to where you can work on them a little more,” Shah said. “We set up different scenarios for the students where they have to go and pull out an injured person from inside what we call the danger zone.”

Shah explained that students are sent to get patients out of the “danger zone,” which could be an active shooter scenario or a situation where an explosive device or hazardous material may be present. That involves first removing the patient from danger to an area where he or she can be more safely “packaged” onto a backboard or stretcher and then transporting the patient to safety.

Although the situation at the paintball range simulated an active shooting scenario, nearly every situation involving EMTs is stressful, said Cindy Barbee, director of the San Jacinto College North EMT program. “Working in our field, many times it is very stressful and whether you’re in a danger situation or not is really not the point,” she said. “When someone is significantly injured or very ill, it’s stressful when the responsibility rests on your shoulders to either save their lives or get them to a hospital where they can get the care they need.”

Barbee reiterated that the most important part is effective teamwork and communication. “As an EMT or paramedic, we have to be able to work together as a team and we have to be able to communicate,” she said. “When those two things fall apart, the whole thing will begin to fall apart.”

The San Jacinto College North program is one of 28 accredited college programs in Texas. It’s a five-semester program divided into three parts: EMT basic, advanced EMT and the paramedic program. Any of the three can be exit points toward eligibility for the National Registry Exam, given by the National Registry of Emergency Medical Technicians.